Polio Eradication Initiative Afghanistan Current Situation of Polio Eradication in Afghanistan Independent Monitoring Board Meeting 29-30 April 2015,Abu Dhabi AFP cases Classification, Afghanistan Year 2013 2014 2015 Reported AFP 1897 2,421 867 cases Confirmed 14 28 1 Compatible 4 6 0 VDPV2 3 0 0 Discarded 1876 2,387 717 Pending 0 0 *149 Total of 2,421 AFP cases reported in 2014 and 28 among them were confirmed Polio while 6 labelled* 123as Adequatecompatible AFP cases Poliopending lab results 26 Inadequate AFP cases pending ERC 21There Apr 2015 is one Polio case reported in 2015 as of 21 April 2015. Region wise Wild Poliovirus Cases 2013-2014-2015, Afghanistan Confirmed cases Region 2013 2014 2015 Central 1 0 0 East 12 6 0 2013 South east 0 4 0 Districts= 10 WPV=14 South 1 17 1 North 0 0 0 Northeast 0 0 0 West 0 1 0 Polio cases increased by 100% in 2014 Country 14 28 1 compared to 2013. Infected districts increased 2014 District= 19 from 10 to 19 in 2014. WPV=28 28 There30 is a case surge in Southern Region while the 25Eastern Region halved the number of cases20 in comparison14 to 2013 Most15 of the infected districts were in South, East10 and South East region in 2014. No of AFP cases AFP of No 1 2015 5 Helmand province reported a case in 2015 District= 01 WPV=01 after0 a period of almost two months indicates 13 14 15 Year 21continuation Apr 2015 of low level circulation. Non Infected Districts Infected Districts Characteristics of polio cases 2014, Afghanistan • All the cases are of WPV1 type, 17/28 (60%) cases are reported from Southern region( Kandahar-13, Helmand-02, and 1 each from Uruzgan and Zabul Province). • 06 cases are reported from Eastern region ( Nangarhar- 3, Laghman- 2, Kunar- 1) • 04 cases are reported from South eastern region (Paktika- 2, 1 each from Khost and Ghazni province. Three of the 4 cases were from displaced population and one from resident. All 4 cases were cross border infections • One case is reported from Farah province of the Western region. • Almost 86% of cases are up to 36 months with median age of 18 months • Both, male and female are affected. Proportion of male cases is higher (54%) than the female cases (46%) • The Median OPV dose is 6 (Range 0-23 Doses) while among non polio AFP cases it is 13 • 05 out of 28 cases did not received any OPV dose neither routine nor SIAs (18%). Nineteen (69%) of the cases did not receive routine OPV dose. 21 Apr 2015 Summary of Laboratory data for Environmental Surveillance, Afghanistan, ( Sep 2013 to date) SN Site Environmental samples collection by Month Total Samples 2013- to date Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 13 13 13 13 14 14 14 14 14 14 14 14 14 14 14 14 15 15 15 Kandahar Province 45 Kandahar city 1 KDH-Khandak 19 2 KDH-Rarobat 19 3 KDH-(Chawnie) 7 closed Helmand Province 35 1 LSK-Bolan Br 14 2 LSK-Radio M 14 3 Nahr-e- Siraj-Zarat Bagh 7 Nangarhar Province 26 Jalalabad city 1 J-abad-Radar Br 13 2 J-abad-Sangi Qala 13 Kunar Province 4 Asadabad city 1 Mandacool 4 Kabul Province 30 Kabul city 1 Qila-e-Zaman K 10 2 Karta-e-Naw 10 3 Khawaja Bughra 10 Afghanistan 140 10 97 33 Wild poliovirus type 1 Summary: Total sites= 11 SL and SL+NPEV Total samples collected= 140 Total samples with results available= 129 Total samples positive for WPV= 23 Total samples positive for SL or SL+NPEV = 83 NPEV Total samples positive for NPEV= 20 Total samples NVI= 3 No Virus Isolated Under Process AFP Surveillance Network , Afghanistan 2014 AFP/ FP Active Surveillance sites by Zero Region Report priority (Polio+ MSLS+ Sites NNT) Weekly Fortnightly Monthly Total BDK 24 154 5 15 32 52 CR 109 407 21 72 234 327 ER 65 155 9 9 72 90 NER 124 240 8 18 103 129 NR 54 211 24 32 97 153 SR 73 176 34 57 85 176 SER 72 64 8 20 44 72 WR 57 161 11 20 55 86 AFG 578 1,568 120 243 722 1,085 Afghanistan has a country-wide network of AFP surveillance. There are 578 AFP focal points, 1,568 health facilities submit Zero Reports and 1,085 are labelled as active surveillance sites. 21 Apr 2015 AFP Surveillance Indicators by Regions, Afghanistan 2013-2014 Detection Stool within 7 EV % SL % NP ADEQ % days of Exp AFP paralysis Regions @2 Rate Reported (2014) AFP Cases (2014) Cases AFP 2013 2013 2014 2013 2014 2013 2014 2014 Badakhshan 11 52 9.47 95 98 78 90 20.9 15.3 6.45 19.23 Central 89 397 8.95 96 97 90 92 17.05 15.1 2.89 5.04 Eastern 38 301 15.72 94 91 88 85 23.30 25.5 7.39 10.30 North eastern 43 301 13.86 98 94 90 86 17.06 20.6 3.57 3.65 Northern 48 331 13.91 94 92 83 84 22.94 18.7 3.23 1.81 South eastern 38 204 10.74 95 98 92 93 21.01 21.5 7.56 9.31 Southern 68 442 13.05 84 82 76 76 24.04 26.2 9.79 9.73 Western 52 391 14.93 97 97 91 90 19.33 23.0 2.76 4.86 National 387 2419 12.50 94 93 86 86 20.51 21.4 5.06 6.57 National Level Major AFP Surveillance Indicators including Non Polio AFP rate, % Adequate samples, detection within 7 days, EV and SL% meet the global criteria At Regional level Southern Region is slightly lacking behind the threshold of 80% 21 Apr 2015 AFP surveillance indicators, in bordering provinces Afghanistan 2013-2014-2015 Detection Stool within 7 NP EV % SL % AFP ADEQ % days of Exp Regions Rate paralysis @2 (2014 Reported Reported ) 2013 2014 2015 2013 2014 2015 2013 2014 2015 2013 2014 2015 AFP Cases (2014) Cases AFP KUNAR 6 45 14.1 91 87 100 85 69 92 21 22 23 12 9 8 NANGARHAR 24 212 17.7 93 91 98 86 89 91 21 28 12 7 11 2 NURISTAN 2 9 9.9 80 78 100 60 44 100 20 11 20 0 22 0 KHOST 9 62 13.4 96 98 100 93 94 100 28 19 8 3 14 0 PAKTIKA 6 42 13.1 93 98 100 93 95 88 20 24 13 10 2 13 PAKTYA 7 43 11.7 93 93 100 86 93 88 14 23 0 7 12 0 HILMAND 29 135 9.3 88 81 98 74 72 72 28 29 23 9 16 15 KANDAHAR 22 192 17.7 83 81 90 77 75 76 21 25 12 9 10 14 ZABUL 8 45 11.3 84 84 89 76 82 79 24 24 16 8 1 11 Most of the Surveillance indicators in the bordering provinces are up to the required level. However, early detection rate in Kandahar, Helmand and Zabul is below the required level of 80% 21 Apr 2015 PEI situation in key bordering Provinces, Afghanistan Key bordering provinces Afghanistan with Pakistan Kunar Zero Dose AFP cases ( 0-59 M) : Decreased from 8 cases in 2013 to 1 case in 2014 Kunar LPDS Priority 1= 3 Districts Nangarhar Nangarhar Khost Zero Dose AFP cases ( 0-59 M) : Decreased from 2 cases in 2013 to Nil in 2014 Paktika LPDS Priority 1= 1 Kandahar Khost Hilmand Zero Dose AFP cases ( 0-59 M) : Increased from 0 case in 2013 to 1 case in 2014 LPDS Priority 1= 0 Kandahar All bordering key provinces Zero Dose AFP cases ( 0-59 M) : Decreased from 7 but Khost indicators show cases in 2013 to 3 cases in 2014 progress with reduction in LPDS Priority 1= 12 Hilmand number of zero doses AFP Zero Dose AFP cases ( 0-59 M) : Decreased from 6 cases in 2014 cases in 2013 to 3 cases in 2014 LPDS Priority 1= 8 21 Apr 2015 Cross Border Districts and Vaccination Points 1-Sarkani-Distric-2- Marawara- District 3-Dangan- District-4-Narai- District (Kunar Province) Total 16 Cross Border Vaccination 5-Momandara-District (Nangarhar Province) Posts Afghanistan 6- Jaji-Aryob, 7-Danda-wa-Patan, ( Paktia Province) Name of the Region Province District 8- Gurbuz, 9+10 Alisher,11-Zazi Maidan (Khost Province) KPK post 12-13- Bermal,14-Terwa, (Paktika Province) Sarkani Nawapas 15-Shamalzai-District (Zabul Province) Marawara Ghakhai Kunar 16-Spin-Boldak-District (Kandahar Province) E Dangam Beenshahi Narrai Dokalam Nangarhar Momandara Torkham Jaji Aryob Gomruk Paktia DandaPatan Sokhta Tanah Gorbuz Gulam Khan Alisher Babrak Tanah Khost SE Alisher Battai ZaziMaidan Sitywan Barmal Angor Ada AFG CB OPV posts Paktika CBTs Afghanistan Barmal Lwara Terwa Qamarden The entire CBTs have vaccinated 1,43 Million targetS age Zabul children Shamalzai inShamalzai 2013 Kandahar SpinBoldak Friendship gate and 1,61 MillionAfg CB OPV in posts 2014. Among these, Torkham team has vaccinated 58%21 Apr and2015 Spin Boldak 37% respectively No of children vaccinated by CBTs name, bordering area of Pakistan and direction of movement, 2014 Pakistan area No of children Region Province District CBT Name Incomings Outgoings bordering CBT vaccinated Kandahar Boldak Spin Boldak Killabullah 571,557 349,674 221,883 South Zabul Shamalazai Shamalazai Killasaifullah 3,512 Nangarhar Momandara Torkham Khybay 898,399 403,512 494,887 Dangam Beenshahi Dir 9,502 East Nari Dokalam Chatral 12,065 Kunar Marawara Ghakhai Bajawar 8,971 Sarkani Nawapas Bajawar 3,559 DandaPatan Sokhta Tanah Kurram Agency 4,112 2,071 2,041 Paktya Jaji Aryob Gomruk Kurram Agency 3,265 1,593 1,672 Khost Babrak Tanah North Wazirestan 27,977 15,826 12,151 Alisher Battai North Wazirestan 10,158 4,688 5,470 SE Khost Gorbuz Gulam Khan North Wazirestan 15,959 8,819 7,140 ZaziMaidan Sitywan North Wazirestan 4,134 1,579 2,555 Barmal Angor Ada South Wazirestan 3,992 2,656 1,336 Paktika Barmal Lwara North Wazirestan 3,170 2,495 675 Terwa Qamarden Zhob 2,728 1,843 885 West Hirat Kohsan Islam Qala 11,933 12 Apr 2015 Cross Border PEI Communication • Project with BBC Pashtu for increased and improved radio messaging will impact on the cross border areas between Pakistan and Afghanistan.